Hernia stapler with integrated mesh manipulator

Abstract

A surgical stapler for use during an open hernia repair comprises an elongated shaft having a handle 120 at its proximal end and a downwardly disposed staple discharge head 130 at its distal end. A squeeze trigger 122 on the handle 120 is operable to cause a supply of staples 160 to be selectively discharged from the port. One or more mesh manipulators 150 are provided on the head 130 and serve to assist in positioning or otherwise manipulating surgical mesh prior to fixation with the staples.

What is claimed is: 
     
       1. A surgical stapler for use during an open hernia repair, comprising:
 an elongated shaft having a handle at its proximal end and a staple discharge head at its distal end, a longitudinal axis of the staple discharge head forming an angle between 30 degrees and 50 degrees relative to the longitudinal axis of the elongated shaft, the staple discharge head defining a staple discharge port, wherein the handle is operable to cause a supply of staples to be selectively discharged from the port; 
 one or more mesh manipulators positioned on the staple discharge head adjacent the staple discharge port, the mesh manipulators configured to penetrate into a surgical mesh to move the surgical mesh to a desired position for stapling; and 
 a staple magazine mounted to the discharge head and to the elongated shaft, wherein a longitudinal axis of the staple magazine is oriented between 40 degrees and 50 degrees relative to the longitudinal axis of the elongated shaft during the open hernia repair. 
 
     
     
       2. The stapler of  claim 1  wherein the one or more mesh manipulators comprise one or more fixed prongs. 
     
     
       3. The stapler of  claim 2  wherein a plurality of fixed prongs are disposed on opposing sides of the discharge port. 
     
     
       4. The stapler of  claim 2  wherein the one or more mesh manipulators comprise a wire having a non-linear portion. 
     
     
       5. The stapler of  claim 1  wherein the one or more mesh manipulators are retractable. 
     
     
       6. The stapler of  claim 1  wherein a staple former in the discharge head is driven by a trigger in the handle via an actuating assembly extending through the shaft. 
     
     
       7. The stapler of  claim 6  wherein the actuating assembly comprises a rigid rod in a straight section of the shaft and a flexible member spanning a curved section of the shaft. 
     
     
       8. A surgical stapler comprising:
 an elongated shaft having a handle at its proximal end, a discharge head at its distal end wherein a longitudinal axis of the discharge head is disposed at an angle between 30 degrees and 50 degrees relative to the longitudinal axis of the elongated shaft, the shaft having a middle portion that spans between the proximal end and the distal end; 
 a magazine of staples mounted between the discharge head and the middle portion of the shaft, a longitudinal axis of the magazine of staples disposed at an angle between 40 degrees and 50 degrees relative to the longitudinal axis of the elongated shaft, the magazine of staples positioned exteriorly to the shaft; and 
 a pusher plate positioned in the discharge head, the pusher plate is configured to move forward in the discharge head to remove a single staple from the magazine of staples. 
 
     
     
       9. The surgical stapler of  claim 8  wherein the discharge head is driven by a trigger in the handle via an actuating assembly extending longitudinally through the shaft. 
     
     
       10. The surgical stapler of  claim 9  wherein the actuating assembly comprises a rigid rod in a straight section of the shaft and a flexible member spanning a curved section of the shaft, and the pusher plate is attached to the flexible member. 
     
     
       11. The surgical stapler of  claim 8  further comprising one or more mesh manipulators extending under the discharge head. 
     
     
       12. The surgical stapler of  claim 11  wherein the one or more mesh manipulators comprise a plurality of fixed prongs. 
     
     
       13. The surgical stapler of  claim 11  wherein the one or more mesh manipulators are retractable. 
     
     
       14. An apparatus for use by a person stapling mesh to body tissue at a site of inguinal hernia surgery, comprising:
 a handle for holding the apparatus adjacent the surgery site, and having a proximal end and a distal end; 
 a rigid shaft having a proximal end and a distal end and a longitudinal axis that spans between the proximal end and the distal end, and the shaft having the proximal end mounted to the distal end of the handle; 
 a staple discharge head having one end with a mounting portion connected to the distal end of the shaft, and having another end with a staple exit port, a longitudinal axis that spans between the ends of the staple discharge head forming an acute angle relative to the longitudinal axis of the shaft; 
 the head adapted to fire a staple out from the head through the port along a line and in a direction away from the handle, wherein the direction of staple firing is at an acute angle relative to the longitudinal axis of the shaft; 
 a plurality of mesh manipulating prongs extending under the staple discharge head in a direction parallel to the longitudinal axis of the staple discharge head, wherein said prongs each include a distal portion having a tip to penetrate into a mesh positioned in a body cavity during inguinal hernia surgery, the mesh manipulating prongs configured to move said mesh to a location for stapling the mesh to body tissue at the surgery site; and 
 a staple magazine having a length that spans between the staple exit port of the discharge head and the rigid shaft, wherein a longitudinal axis of the staple magazine is oriented at an acute angle relative to the longitudinal axis of the rigid shaft during the open hernia repair. 
 
     
     
       15. The apparatus of  claim 14  wherein the prongs extend at least about 3 mm distal to a plane defined by a staple outlet port in the head. 
     
     
       16. The surgical stapler of  claim 10  wherein the pusher plate includes a forming finger to remove the single staple from the magazine of staples. 
     
     
       17. The surgical stapler of  claim 8  further comprising a stiffener provided in the elongated shaft to increase rigidity of the shaft. 
     
     
       18. The apparatus of  claim 14  wherein the longitudinal axis of the staple discharge head forming the acute angle relative to the longitudinal axis of the shaft is between 30 degrees and 50 degrees.